Effects of the phosphodiesterase III inhibitors olprinone, milrinone, and amrinone on hepatosplanchnic oxygen metabolism

Gentaro Iribe, Haruhiko Yamada, Akira Matsunaga, Nozomu Yoshimura

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Objective: To measure the hepatic venous oxygen saturation in patients after cardiac surgery and to compare the effects of olprinone (OLP), a newly synthesized phosphodiesterase III inhibitor, with those of milrinone (MIL) and amrinone (AMR) on hepatosplanchnic oxygen dynamics. Phosphodiesterase III inhibitors are used to improve the hemodynamic state after cardiac surgery. However, the effect of these agents on the hepatosplanchnic circulation has not been investigated thoroughly. Design: Prospective, randomized study. Setting: University hospital intensive care unit (ICU). Patients: Twenty-nine patients undergoing elective cardiac surgery. Measurements and Main Results: In each patient, a 7.5-Fr oximeter catheter was placed in the hepatic vein via the right femoral vein. Catheterization was completed before admission to the ICU, and the study was performed 8 to 24 hrs after surgery, after obtaining stable systemic hemodynamics in the ICU. The patients were assigned randomly to three groups, and they received one of three drugs for 2 hrs (OLP group, 0.3 μg/kg/min of OLP; MIL group, 0.5 μg/kg/min of MIL; AMR group, 10 μg/kg/min of AMR). The authors did not change the patient's hemodynamic interventions, including catecholamines and vasodilators, throughout the study period. Arterial and hepatic venous blood gas data and hemodynamic data (via a pulmonary artery catheter) were obtained before and after drug infusion. Using these data, the authors calculated systemic oxygen delivery and consumption, the systemic oxygen extraction ratio and the hepatosplanchnic oxygen extraction ratio, and the change in hepatosplanchnic blood flow using Fick's equation. Although the increases in cardiac index were not significantly different among the three groups, hepatic venous oxygen saturation increased significantly only in the OLP group (from 47.1% ± 2.6% to 57.0% ± 1.5% in the OLP group, from 48.4% ± 2.3% to 50.9% ± 2.6% in the MIL group, and from 49.8% ± 3.6% to 50.8% ± 1.7% in the AMR group). The calculated hepatosplanchnic blood flow change was significantly larger in the OLP group than in the other groups (30.1% ± 5.7% in the OLP group, 9.3% ± 5.1% in the MIL group, and 2.6% ± 6.5% in the AMR group). Conclusions: These results suggest that OLP enhances hepatosplanchnic blood flow and thus may be beneficial in protecting the hepatosplanchnic organs after cardiac surgery.

Original languageEnglish
Pages (from-to)743-748
Number of pages6
JournalCritical Care Medicine
Volume28
Issue number3
Publication statusPublished - 2000
Externally publishedYes

Fingerprint

Amrinone
Type 3 Cyclic Nucleotide Phosphodiesterases
Milrinone
Phosphodiesterase Inhibitors
Oxygen
Thoracic Surgery
Hemodynamics
Intensive Care Units
Liver
Catheters
Hepatic Veins
Femoral Vein
olprinone
Vasodilator Agents
Oxygen Consumption
Catheterization
Pharmaceutical Preparations
Pulmonary Artery
Catecholamines
Gases

Keywords

  • Amrinone
  • Cardiac surgery
  • Hepatic venous oxygen saturation
  • Milrinone
  • Olprinone
  • Phosphodiesterase III inhibitor
  • Splanchnic oxygen metabolism

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Effects of the phosphodiesterase III inhibitors olprinone, milrinone, and amrinone on hepatosplanchnic oxygen metabolism. / Iribe, Gentaro; Yamada, Haruhiko; Matsunaga, Akira; Yoshimura, Nozomu.

In: Critical Care Medicine, Vol. 28, No. 3, 2000, p. 743-748.

Research output: Contribution to journalArticle

Iribe, Gentaro ; Yamada, Haruhiko ; Matsunaga, Akira ; Yoshimura, Nozomu. / Effects of the phosphodiesterase III inhibitors olprinone, milrinone, and amrinone on hepatosplanchnic oxygen metabolism. In: Critical Care Medicine. 2000 ; Vol. 28, No. 3. pp. 743-748.
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title = "Effects of the phosphodiesterase III inhibitors olprinone, milrinone, and amrinone on hepatosplanchnic oxygen metabolism",
abstract = "Objective: To measure the hepatic venous oxygen saturation in patients after cardiac surgery and to compare the effects of olprinone (OLP), a newly synthesized phosphodiesterase III inhibitor, with those of milrinone (MIL) and amrinone (AMR) on hepatosplanchnic oxygen dynamics. Phosphodiesterase III inhibitors are used to improve the hemodynamic state after cardiac surgery. However, the effect of these agents on the hepatosplanchnic circulation has not been investigated thoroughly. Design: Prospective, randomized study. Setting: University hospital intensive care unit (ICU). Patients: Twenty-nine patients undergoing elective cardiac surgery. Measurements and Main Results: In each patient, a 7.5-Fr oximeter catheter was placed in the hepatic vein via the right femoral vein. Catheterization was completed before admission to the ICU, and the study was performed 8 to 24 hrs after surgery, after obtaining stable systemic hemodynamics in the ICU. The patients were assigned randomly to three groups, and they received one of three drugs for 2 hrs (OLP group, 0.3 μg/kg/min of OLP; MIL group, 0.5 μg/kg/min of MIL; AMR group, 10 μg/kg/min of AMR). The authors did not change the patient's hemodynamic interventions, including catecholamines and vasodilators, throughout the study period. Arterial and hepatic venous blood gas data and hemodynamic data (via a pulmonary artery catheter) were obtained before and after drug infusion. Using these data, the authors calculated systemic oxygen delivery and consumption, the systemic oxygen extraction ratio and the hepatosplanchnic oxygen extraction ratio, and the change in hepatosplanchnic blood flow using Fick's equation. Although the increases in cardiac index were not significantly different among the three groups, hepatic venous oxygen saturation increased significantly only in the OLP group (from 47.1{\%} ± 2.6{\%} to 57.0{\%} ± 1.5{\%} in the OLP group, from 48.4{\%} ± 2.3{\%} to 50.9{\%} ± 2.6{\%} in the MIL group, and from 49.8{\%} ± 3.6{\%} to 50.8{\%} ± 1.7{\%} in the AMR group). The calculated hepatosplanchnic blood flow change was significantly larger in the OLP group than in the other groups (30.1{\%} ± 5.7{\%} in the OLP group, 9.3{\%} ± 5.1{\%} in the MIL group, and 2.6{\%} ± 6.5{\%} in the AMR group). Conclusions: These results suggest that OLP enhances hepatosplanchnic blood flow and thus may be beneficial in protecting the hepatosplanchnic organs after cardiac surgery.",
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T1 - Effects of the phosphodiesterase III inhibitors olprinone, milrinone, and amrinone on hepatosplanchnic oxygen metabolism

AU - Iribe, Gentaro

AU - Yamada, Haruhiko

AU - Matsunaga, Akira

AU - Yoshimura, Nozomu

PY - 2000

Y1 - 2000

N2 - Objective: To measure the hepatic venous oxygen saturation in patients after cardiac surgery and to compare the effects of olprinone (OLP), a newly synthesized phosphodiesterase III inhibitor, with those of milrinone (MIL) and amrinone (AMR) on hepatosplanchnic oxygen dynamics. Phosphodiesterase III inhibitors are used to improve the hemodynamic state after cardiac surgery. However, the effect of these agents on the hepatosplanchnic circulation has not been investigated thoroughly. Design: Prospective, randomized study. Setting: University hospital intensive care unit (ICU). Patients: Twenty-nine patients undergoing elective cardiac surgery. Measurements and Main Results: In each patient, a 7.5-Fr oximeter catheter was placed in the hepatic vein via the right femoral vein. Catheterization was completed before admission to the ICU, and the study was performed 8 to 24 hrs after surgery, after obtaining stable systemic hemodynamics in the ICU. The patients were assigned randomly to three groups, and they received one of three drugs for 2 hrs (OLP group, 0.3 μg/kg/min of OLP; MIL group, 0.5 μg/kg/min of MIL; AMR group, 10 μg/kg/min of AMR). The authors did not change the patient's hemodynamic interventions, including catecholamines and vasodilators, throughout the study period. Arterial and hepatic venous blood gas data and hemodynamic data (via a pulmonary artery catheter) were obtained before and after drug infusion. Using these data, the authors calculated systemic oxygen delivery and consumption, the systemic oxygen extraction ratio and the hepatosplanchnic oxygen extraction ratio, and the change in hepatosplanchnic blood flow using Fick's equation. Although the increases in cardiac index were not significantly different among the three groups, hepatic venous oxygen saturation increased significantly only in the OLP group (from 47.1% ± 2.6% to 57.0% ± 1.5% in the OLP group, from 48.4% ± 2.3% to 50.9% ± 2.6% in the MIL group, and from 49.8% ± 3.6% to 50.8% ± 1.7% in the AMR group). The calculated hepatosplanchnic blood flow change was significantly larger in the OLP group than in the other groups (30.1% ± 5.7% in the OLP group, 9.3% ± 5.1% in the MIL group, and 2.6% ± 6.5% in the AMR group). Conclusions: These results suggest that OLP enhances hepatosplanchnic blood flow and thus may be beneficial in protecting the hepatosplanchnic organs after cardiac surgery.

AB - Objective: To measure the hepatic venous oxygen saturation in patients after cardiac surgery and to compare the effects of olprinone (OLP), a newly synthesized phosphodiesterase III inhibitor, with those of milrinone (MIL) and amrinone (AMR) on hepatosplanchnic oxygen dynamics. Phosphodiesterase III inhibitors are used to improve the hemodynamic state after cardiac surgery. However, the effect of these agents on the hepatosplanchnic circulation has not been investigated thoroughly. Design: Prospective, randomized study. Setting: University hospital intensive care unit (ICU). Patients: Twenty-nine patients undergoing elective cardiac surgery. Measurements and Main Results: In each patient, a 7.5-Fr oximeter catheter was placed in the hepatic vein via the right femoral vein. Catheterization was completed before admission to the ICU, and the study was performed 8 to 24 hrs after surgery, after obtaining stable systemic hemodynamics in the ICU. The patients were assigned randomly to three groups, and they received one of three drugs for 2 hrs (OLP group, 0.3 μg/kg/min of OLP; MIL group, 0.5 μg/kg/min of MIL; AMR group, 10 μg/kg/min of AMR). The authors did not change the patient's hemodynamic interventions, including catecholamines and vasodilators, throughout the study period. Arterial and hepatic venous blood gas data and hemodynamic data (via a pulmonary artery catheter) were obtained before and after drug infusion. Using these data, the authors calculated systemic oxygen delivery and consumption, the systemic oxygen extraction ratio and the hepatosplanchnic oxygen extraction ratio, and the change in hepatosplanchnic blood flow using Fick's equation. Although the increases in cardiac index were not significantly different among the three groups, hepatic venous oxygen saturation increased significantly only in the OLP group (from 47.1% ± 2.6% to 57.0% ± 1.5% in the OLP group, from 48.4% ± 2.3% to 50.9% ± 2.6% in the MIL group, and from 49.8% ± 3.6% to 50.8% ± 1.7% in the AMR group). The calculated hepatosplanchnic blood flow change was significantly larger in the OLP group than in the other groups (30.1% ± 5.7% in the OLP group, 9.3% ± 5.1% in the MIL group, and 2.6% ± 6.5% in the AMR group). Conclusions: These results suggest that OLP enhances hepatosplanchnic blood flow and thus may be beneficial in protecting the hepatosplanchnic organs after cardiac surgery.

KW - Amrinone

KW - Cardiac surgery

KW - Hepatic venous oxygen saturation

KW - Milrinone

KW - Olprinone

KW - Phosphodiesterase III inhibitor

KW - Splanchnic oxygen metabolism

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